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  • 551.
    Wanhainen, Anders
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Svensjö, Sverker
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Tillberg, Martina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Mani, Kevin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Screening för bukaortaaneurysm i Uppsala: Goda erfarenheter av de första fyra åren – resten av Sverige är på väg2010In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 107, no 38, p. 2232-2236Article in journal (Refereed)
  • 552.
    Wanhainen, Anders
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Themudo, Raquel
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Oncology, Radiology and Clinical Immunology, Radiology.
    Ahlström, Håkan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Oncology, Radiology and Clinical Immunology, Radiology.
    Lind, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Johansson, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Oncology, Radiology and Clinical Immunology, Radiology.
    Thoracic and abdominal aortic dimension in 70-year-old men and women: a population-based whole-body magnetic resonance imaging (MRI) study2008In: Journal of Vascular Surgery, ISSN 0741-5214, E-ISSN 1097-6809, Vol. 47, no 3, p. 504-12Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The aim of this population-based study was to determine the optimal dividing-line between normal aorta and aneurysm for different aortic segments in 70-year-old men and women by means of whole-body magnetic resonance imaging. METHODS: Two hundred thirty-one subjects (116 men), randomly recruited from a population-based cohort study, were included. The smallest outer diameter (dia) was measured on the axial survey scan on six predefined aortic segments: (1) ascending aorta, (2) descending aorta, (3) supraceliac aorta, (4) suprarenal aorta, (5) largest infrarenal abdominal aorta, and (6) aortic bifurcation. Relative aortic dia were calculated by dividing a given aortic dia by the suprarenal aortic dia. The dividing-line between normal aorta and aneurysm at different aortic segments was estimated by taking the mean dia +2 SD and/or mean ratio of the aortic segment to the suprarenal aorta +2 SD. RESULTS: The mean dia of the six segments were 4.0 cm (SD 0.4), 3.2 cm (0.3), 3.0 cm (0.3), 2.8 cm (0.3), 2.4 cm (0.5), and 2.3 cm (0.3) in men. The corresponding dia in women were 3.4 cm (0.4), 2.8 cm (0.3), 2.7 cm (0.3), 2.7 cm (0.3), 2.2 cm (0.3), and 2.0 cm (0.2). The mean ratio to the suprarenal aorta was 1.4 (SD 0.2) for the ascending aorta, 1.2 (0.1) for the descending aorta, and 0.9 (0.2) for the infrarenal aorta in men. The corresponding ratios in women were 1.3 (0.2), 1.0 (0.1), and 0.8 (0.1). CONCLUSION: For men the suggested dividing-line (dia and ratio) between normal aorta and aneurysm for the ascending aorta is 4.7 cm dia and 1.8 ratio, for the descending aorta 3.7 cm dia and 1.5 ratio, and for the infrarenal aorta is 3.0 cm dia and 1.1 ratio. The corresponding dividing-lines for women are 4.2 cm dia and 1.7 ratio, 3.3 cm dia and 1.3 ratio, and 2.7 cm dia and 1.0 ratio.

  • 553.
    Wanhainen, Anders
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Thorbjørnsen, K
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Endo-VAC: a novel treatment option for infected vascular reconstructions2016In: Vascular and Endovascular Controversies Update / [ed] Greenhalgh R, London: BIBA Publishing , 2016, p. 357-362Chapter in book (Refereed)
  • 554.
    Wanhainen, Anders
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Verzini, Fabio
    Turin Univ, Dept Surg Sci, Turin, Italy.
    Van Herzeele, Isabelle
    Univ Hosp Ghent, Dept Thorac & Vasc Surg, Ghent, Belgium.
    Allaire, Eric
    Univ Paris Est Creteil, Mondor Univ Hosp, AP HP, Dept Vasc Surg, Creteil, France.
    Bown, Matthew
    Univ Leicester, NIHR Leicester Biomed Res Ctr, Leicester, Leics, England.
    Cohnert, Tina
    Med Univ Graz, Dept Vasc Surg, Graz Univ Hosp, Graz, Austria.
    Dick, Florian
    Kantonsspital, Dept Vasc Surg, St Gallen, Switzerland; Univ Bern, Bern, Switzerland.
    van Herwaarden, Joost
    Univ Med Ctr Utrecht, Dept Vasc Surg, Utrecht, Netherlands.
    Karkos, Christos
    Aristotle Univ Thessaloniki, Vasc Surg Unit,, Med Sch, Thessaloniki, Greece.
    Koelemay, Mark
    Acad Med Ctr, Dept Surg, Amsterdam, Netherlands.
    Koelbel, Tilo
    Univ Heart Ctr, German Aort Ctr Hamburg, Dept Vasc Med, Hamburg, Germany.
    Loftus, Ian
    St Georges Healthcare NHS Fdn Trust, London, England.
    Mani, Kevin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Melissano, Germano
    Univ Vita Salute San Raffaele Milano, Dept Vasc Surg, Milan, Italy.
    Powell, Janet
    Imperial Coll, Vasc Surg Res Grp, London, England.
    Szeberin, Zoltan
    Semmelweis Univ, Dept Vasc Surg, Budapest, Hungary.
    Chakfe, Nabil (Contributor)
    European Society for Vascular Surgery, Stratsbourg, France.
    Debus, Sebastian (Contributor)
    European Society for Vascular Surgery, Hamburg, Germany.
    Hinchliffe, Rob (Contributor)
    European Society for Vascular Surgery, Brinstol, United Kingdom.
    Kakkos, Stavros (Contributor)
    European Society for Vascular Surgery, Patras, Greece.
    Konca, Igor (Contributor)
    European Society for Vascular Surgery, Belgrade, Serbia.
    Kolh, Philippe (Contributor)
    European Society for Vascular Surgery, Liege, Belgium.
    Lindholt, Jes S. (Contributor)
    European Society for Vascular Surgery, Odense, Denmark.
    de Vega, Melina (Contributor)
    European Society for Vascular Surgery, Bilbao, Spain.
    Vermassen, Frank (Contributor)
    European Society for Vascular Surgery, Ghent, Belgium.
    Björck, Martin (Contributor)
    European Society for Vascular Surgery, Uppsala, Sweden.
    Cheng, Stephen (Contributor)
    European Society for Vascular Surgery, Hong Kong, China.
    Dalman, Ronald (Contributor)
    European Society for Vascular Surgery, Stanford, USA.
    Davidovic, Lazar (Contributor)
    European Society for Vascular Surgery, Belgrade, Serbia.
    Dona, Konstantinos (Contributor)
    European Society for Vascular Surgery, Munster, Germany.
    Earnshaw, Jonothan (Contributor)
    European Society for Vascular Surgery, Gloucester, United Kingdom.
    Eckstein, Hans-Henning (Contributor)
    European Society for Vascular Surgery, Munich, Germany.
    Golledge, Jonathan (Contributor)
    European Society for Vascular Surgery, Queensland, Australia.
    Ricco, Jean-Baptiste (Contributor)
    European Society for Vascular Surgery, Poitiers, France.
    Mastracci, Tara (Contributor)
    European Society for Vascular Surgery, London, United Kingdom.
    Haulon, Stephan (Contributor)
    European Society for Vascular Surgery, Paris, France.
    Naylor, Ross (Contributor)
    European Society for Vascular Surgery, Leicester, United Kingdom.
    Verhagen, Hence (Contributor)
    European Society for Vascular Surgery, Rotterdam, Netherlands.
    Editor's Choice – European Society for Vascular Surgery (ESVS) 2019 Clinical Practice Guidelines on the Management of Abdominal Aorto-iliac Artery Aneurysms2019In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 57, no 1, p. 8-93Article in journal (Refereed)
  • 555. Willems, M. C. M.
    et al.
    van der Vliet, J. Adam
    Williams, V.
    Kool, L. J. Schultze
    Bergqvist, David
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Blankensteijn, J. D.
    Assessing endovascular skills using the Simulator for Testing and Rating Endovascular Skills (STRESS) machine2009In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 37, no 4, p. 431-6Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Endovascular techniques are an integral part of modern-day vascular surgery practice and training. Nevertheless, validated in vitro assessment tools for these skills are scarce. This study describes the development and pilot testing of the Simulator for Testing and Rating Endovascular Skills (STRESS machine). DESIGN: The design was kept straightforward and compact, without the need for contrast or fluoroscopy. A specific technical skill score was designed analogous to the Imperial College Evaluation of Procedural Skill (ICEPS), an assessment score for open surgical skill. This score was combined with an already validated global rating assessment to form the total score (TS). METHODS: A pilot study was carried out on 18 candidates of varying levels of expertise: novice, intermediate and expert, who were assessed by two independent observers to test inter-observer reliability. RESULTS: Inter-observer reliability was excellent, Cronbach's alpha coefficient of the TS was 0.94 (95% confidence interval: 0.84-0.97). A one-way analysis of variance (ANOVA) showed a significant difference between the novice and expert groups (p<0.001), between the novice and intermediate groups (p<0.01) and between the intermediate and expert groups (p<0.05). CONCLUSION: The STRESS machine, in combination with the specific technical skill score and global rating assessment, provides a reliable method of discriminating between the novice, intermediate and expert candidates with excellent inter-observer variability.

  • 556. Writing Committee,
    et al.
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Koelemay, M
    Acosta, S
    Bastos Goncalves, F
    Kölbel, T
    Kolkman, J J
    Lees, T
    Lefevre, J H
    Menyhei, G
    Oderich, G
    Esvs Guidelines Committee,
    Kolh, P
    de Borst, G J
    Chakfe, N
    Debus, S
    Hinchliffe, R
    Kakkos, S
    Koncar, I
    Sanddal Lindholt, J
    Vega de Ceniga, M
    Vermassen, F
    Verzini, F
    Document Reviewers,
    Geelkerken, B
    Gloviczki, P
    Huber, T
    Naylor, R
    Editor's Choice - Management of the Diseases of Mesenteric Arteries and Veins: Clinical Practice Guidelines of the European Society of Vascular Surgery (ESVS)2017In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 53, no 4, p. 460-510, article id S1078-5884(17)30058-8Article in journal (Refereed)
  • 557. Writing Committee,
    et al.
    Riambau, V
    Böckler, D
    Brunkwall, J
    Cao, P
    Chiesa, R
    Coppi, G
    Czerny, M
    Fraedrich, G
    Haulon, S
    Jacobs, M J
    Lachat, M L
    Moll, F L
    Setacci, C
    Taylor, P R
    Thompson, M
    Trimarchi, S
    Verhagen, H J
    Verhoeven, E L
    Esvs Guidelines Committee,
    Kolh, P
    de Borst, G J
    Chakfé, N
    Debus, E S
    Hinchliffe, R J
    Kakkos, S
    Koncar, I
    Lindholt, J S
    Vega de Ceniga, M
    Vermassen, F
    Verzini, F
    Document Reviewers,
    Kolh, P
    Black, J H
    Busund, R
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Dake, M
    Dick, F
    Eggebrecht, H
    Evangelista, A
    Grabenwöger, M
    Milner, R
    Naylor, A R
    Ricco, J-B
    Rousseau, H
    Schmidli, J
    Editor's Choice - Management of Descending Thoracic Aorta Diseases: Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS).2017In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 53, no 1, p. 4-52, article id S1078-5884(16)30178-2Article in journal (Refereed)
  • 558. Ye, Wei
    et al.
    Liu, Chang-Wei
    Ricco, Jean-Baptiste
    Mani, Kevin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Zeng, Rong
    Jiang, Jingmei
    Early and late outcomes of percutarreous treatment of TransAtlantic Inter-Society Consensus class C and D aorto-iliac lesions2011In: Journal of Vascular Surgery, ISSN 0741-5214, E-ISSN 1097-6809, Vol. 53, no 6, p. 1728-1737Article, review/survey (Refereed)
    Abstract [en]

    Objectives: The aim of this study was to analyze the technical success and long-term patency of the endovascular treatment of TransAtlantic Inter-Society Consensus (TASC) C and D aorto-iliac arterial lesions. Methods: All studies reporting original series of patients published in English between 2000 and 2010 were enrolled into meta-analysis. Separate meta-analyses were performed for groups with immediate technical success, 12-month patency, and long-term outcomes. Subgroup analyses were performed to determine if there were differences in outcomes between patients with varying types of lesions (TASC C or D lesions) or between different stenting strategies, including primary or selective stenting. Results: Sixteen articles consisting of 958 patients were enrolled in this meta-analysis. The pooled estimate for technical success was 92.8% (95% confidence interval [CI], 89.8%-95.0%, 749 cases). Primary patency at 12 months was 88.7% (95% CI, 85.9%-91.0%, 787 cases). Subgroup analyses demonstrated a technical success rate of 93.7% (95% CI, 88.9%-96.5%) and a 12-month primary patency rate of 89.6% (95% CI, 84.8%-93.0%) for TASC C lesions. For TASC D lesions, these rates were 90.1% (95% CI, 76.6%-96.2%) and 87.3% (95% CI, 82.5%-90.9%), respectively. The technical success and 12-month primary patency rates for primary stenting were 94.2% (95% CI, 91.8%-95.9%) and 92.1% (95% CI, 89.0%-94.3%), respectively; for selective stenting, these rates were 88.0% (95% CI, 67.9%-96.2%) and 82.9% (95% CI, 72.2%-90.0%), respectively. The long-term, primary patency rates for patients receiving primary stenting were significantly better than those receiving selective stenting. Publication bias was not significant for these analyses. Conclusions: This study demonstrates that early and midterm outcomes of endovascular treatment for TASC C and D aorto-iliac lesions were acceptable, with a better patency for primary stenting than selective stenting.

  • 559.
    Zarrouk, M.
    et al.
    Skane Univ Hosp, Dept Vasc Dis, S-20502 Malmo, Sweden..
    Lundqvist, A.
    IHE, Swedish Inst Hlth Econ, Lund, Sweden..
    Holst, J.
    Skane Univ Hosp, Dept Vasc Dis, S-20502 Malmo, Sweden..
    Troeng, Thomas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Gottsater, A.
    Skane Univ Hosp, Dept Vasc Dis, S-20502 Malmo, Sweden..
    Cost-effectiveness of Screening for Abdominal Aortic Aneurysm in Combination with Medical Intervention in Patients with Small Aneurysms2016In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 51, no 6, p. 766-773Article in journal (Refereed)
    Abstract [en]

    Objectives: Screening for abdominal aortic aneurysm (AAA) among 65 year old men has been proven costeffective, but nowadays is conducted partly under new conditions. The prevalence of AAA has decreased, and endovascular aneurysm repair (EVAR) has become the predominant surgical method for AAA repair in many centers. At the Malmo Vascular Center pharmacological secondary prevention with statins, antiplatelet therapy, and blood pressure reduction is initiated and given to all patients with AAA. This study evaluates the costeffectiveness of AAA screening under the above mentioned conditions. Methods: This was a Markov cohort simulation. A total of 4,300 65 year old men were invited to annual AAA screening; the attendance rate was 78.3% and AAA prevalence was 1.8%. A Markov model with 11 health states was used to evaluate cost-effectiveness of AAA screening. Background data on rupture risks, costs, and effectiveness of surgical interventions were obtained from the participating unit, the national Swedvasc Registry, and from the scientific literature. Results: The additional costs of the screening strategy compared with no screening were 169 per person and year. The incremental health gain per subject in the screened cohort was 0.011 additional quality adjusted life years (QALYs), corresponding to an incremental cost-effectiveness ratio (ICER) of 15710 per QALY. Assuming a 10% reduction of all cause mortality, the incremental cost of screening was 175 per person and year. The gain per subject in the screened cohort was 0.013 additional QALYs, corresponding to an ICER of 13922 per QALY Conclusions: AAA screening remains cost-effective according to both the Swedish recommendations and the UK National Institute for Health and Care Excellence recommendations in the new era of lower AAA prevalence, EVAR as the predominant surgical method, and secondary prevention for all AAA patients.

  • 560.
    Ålund, Martina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Mani, Kevin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Wanhainen, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Selective screening for abdominal aortic aneurysm among patients referred to the vascular laboratory2008In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 35, no 6, p. 669-74Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Patients examined for peripheral arterial disease at the vascular laboratory, Uppsala University Hospital, are since 1993 screened for abdominal aortic aneurysm (AAA). The objective of this study was to study the prevalence of AAA found at this selective high-risk screening. METHODS: All files in the vascular laboratory were retrospectively reviewed. Of 9296 persons examined with arterial duplex between 1993 and October 2005, 5924 were screened for AAA. The primary target vessel was the carotid arteries in 3772 subjects, the renal arteries in 1529 subjects and the lower extremity arteries in 1457 subjects. An AAA was defined as an infrarenal aortic diameter >/=30mm. RESULTS: 179 subjects were found to have an AAA. In a logistic regression model male gender, age and duplex-verified arterial stenosis were independently associated with AAA (odds ratio 3.2, 2.0/20 years and 2.0, respectively, p<0.001). In men <60 years the AAA prevalence was 0.9% (95% confidence interval 0.2-1.6%) when arterial stenosis was absent and 1.5% (0.0-3.2%) when present. In men >/=60 years the AAA prevalence was 4.0% (3.0-5.1%) when no arterial stenosis was found and 7.3% (5.7-8.9%) when found. The corresponding prevalences in women were 0%, 0%, 1.2% (0.5-1.8%), and 3.1% (1.9-4.3%), respectively. CONCLUSIONS: Men >/=60 years referred for arterial examination have a significant risk of having an AAA while only women >/=65 years with a duplex verified arterial stenosis have a sufficient risk of having an AAA. Studies to evaluate the benefit of selective high-risk screening are warranted.

  • 561.
    Ögren, Mats
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Bergqvist, David
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Acosta, S
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Sternby, N H
    High incidence of concomitant venous thromboembolism in patients with portal vein thrombosis: a population study based on 23 796 consecutive autopsies2007In: Journal of Thrombosis and Haemostasis, ISSN 1538-7933, E-ISSN 1538-7836, Vol. 5, no 1, p. 198-200Article in journal (Refereed)
  • 562.
    Ögren, Mats
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Bergqvist, David
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Acosta, Stefan
    Eriksson, Henry
    Sternby, Nils H.
    Portal vein thrombosis: Prevalence, patient characteristics and lifetime risk: A population study based on 23796 consecutive autopsies2006In: World Journal of Gastroenterology, ISSN 1007-9327, E-ISSN 2219-2840, Vol. 12, no 13, p. 2115-2119Article in journal (Refereed)
    Abstract [en]

    AIM: To assess the lifetime cumulative incidence of portal venous thrombosis (PVT) in the general population.

    METHODS: Between 1970 and 1982, 23 796 autopsies, representing 84% of all in-hospital deaths in the Malmo city population, were performed, using a standardised protocol including examination of the portal vein. PVT patients were characterised and the PVT prevalence at autopsy, an expression of life-time cumulative incidence, assessed in high-risk disease categories and expressed in terms of odds ratios and 95% CI.

    RESULTS: The population prevalence of PVT was 1.0%. Of the 254 patients with PVT 28% had cirrhosis, 23% primary and 44% secondary hepatobiliary malignancy, 10% major abdominal infectious or inflammatory disease and 3% had a myeloproliferative disorder. Patients with both cirrhosis and hepatic carcinoma had the highest PVT risk, OR 17.1 (95% CI 11.1-26.4). In 14% no cause was found; only a minority of them had developed portal-hypertension-related complications.

    CONCLUSION: In this population-based study, PVT was found to be more common than indicated by previous clinical series. The markedly excess risk in cirrhosis and hepatic carcinoma should warrant an increased awareness in these patients for whom prospective studies of directed intervention might be considered.

  • 563.
    Ögren, Mats
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Lindblad, Bengt
    Engström, Gunnar
    Hedblad, Bo
    Janzon, Lars
    High incidence of vascular reconstructions in socioeconomically deprived areas of an urban Swedish population2007In: British Journal of Surgery, ISSN 0007-1323, E-ISSN 1365-2168, Vol. 94, no 2, p. 183-188Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: In Malmö approximately 250,000 citizens live in 17 administrative areas with substantial socioeconomic differences. At the single centre for arterial reconstruction, Malmö University Hospital, all procedures are registered prospectively. METHODS: Between 1987 and 2002, 1832 Malmö citizens underwent reconstruction for peripheral arterial disease, either intermittent claudication (IC) or critical leg ischaemia (CLI). A socioeconomic score based on migration rate, percentage of residents with foreign citizenship/residents with foreign background, social welfare support dependency and unemployment rate has previously been developed and validated for each area. The relationship between socioeconomic score and area-specific standardized morbidity ratios (SMRs) after vascular reconstruction was analysed by population-weighted linear regression. RESULTS: The mean incidence of vascular reconstruction was 76 (range 27-106) per 100,000 person years. Age- and sex-adjusted SMRs ranged from 0.57 to 1.39. A strong correlation between SMR and socioeconomic score was found overall (R=0.63; P=0.007), in men (R=0.63; P=0.007) and in women (R=0.58; P=0.039), and for IC (R=0.58; P=0.015) and CLI (R=0.58; P=0.015). CONCLUSION: In an urban population with similar access to medical care, vascular reconstruction rates varied substantially. High-rate areas were characterized by inferior socioeconomic circumstances and a higher prevalence of smoking, hypertension and obesity.

  • 564.
    Ögren, Mats
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Lindblad, Bengt
    Engström, Gunnar
    Hedblad, Bo
    Janzon, Lars
    Perifer artärsjukdom kan vara en klassfråga: Ekologisk Malmöstudie visar stora incidensskillnader mellan närområden2007In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 104, no 35, p. 2437-2438Article in journal (Refereed)
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